The prevalence of post-traumatic stress disorder in the joint customers of adolescent psychiatry and child welfare services

Background This study examined the prevalence of post-traumatic stress disorder (PTSD) in patients treated in specialized adolescent psychiatry units and the association between PTSD and placement by child welfare in out-of-home care.

Methods The study sample consisted of 7973 adolescents treated in an adolescent psychiatry unit in 2015–2019. Information on the diagnoses and out-of home placement of the adolescents, and the socioeconomic and marital status of the parents, as well as their psychiatric diagnoses, were derived from national registers. The Chi-square test was used for categorical, and Wilcoxon test for continuous variables when comparing the placed and non-placed. The association between PTSD and placement was examined using logistic regression.

Results The prevalence of PTSD in the study sample was 2.9%. The incidence was higher in the placed (3.8%) than in the non-placed (2.6%, p=0.005). PTSD was associated with placement (OR 1.5; 95% CI 1.0-2.2; p=0.032). The parents' psychiatric diagnoses and the mother's socioeconomic status were also signficantly associated with the placement.

Conclusions PTSD was significantly associated with placement in patients treated in adolescent psychiatry. Trauma-related symptoms and treatment should be in focus when considering actions in child welfare services.

Valentin Harikkala, Katri Lahti, Helena Ollila, Max Karukivi